If you need mental health help you may see someone from one or several of the professional groups listed here. While each profession has some distinct responsibilities in relation to mental health the trend is increasingly towards team work and a sharing of the roles undertaken. All have a responsibility for assessing the needs of those they see and ensuring that their needs are met by a service appropriate to them and for working in a co-ordinated way with colleagues from other professions.

GPs

Most of us will first contact our GP if we have a mental health problem. Often your GP him/herself will be able to help with treatment. Mental health problems account for some 40% of a typical GP's workload. However If you feel that talking through your problems in greater depth may help alleviate or resolve them, then your GP can refer you to a professionally trained counsellor based in the surgery.
If you decide with your doctor that you need specialist mental health assessment and treatment then he can refer you on to a Community Mental Health Team (CMHT).

Psychiatrists

Consultant Psychiatrists are medically qualified doctors who have undertaken specialised training in the treatment and care of people with mental illness. While the majority of psychiatrists are employed to care for people between the ages of 16- 70, some specialise in working with children or older people. Others work with drug users or "mentally disordered offenders".
Consultants work with both In patient teams and with Community Mental Health Teams. The consultant psychiatrist is usually the most senior member of the care team with overall responsibility for patient assessment and care. The Consultant will usually have junior doctors working under his supervison, (Senior House Officers and Registrars).
Since the 1990's psychiatry has been dominated by biochemical explanations for 'mental illness' as opposed to the psychological and social approaches of the sixties and seventies. This has increasingly led to psychiatrist's specialising in drug treatments for mental health problems while relying on other members of the team to explore psychological or social methods of care.

Mental Health Nurses and Community Mental Health Nurses

Mental Health Nurses make up the largest professional group involved in mental health care and will be found working in a wide range of different settings from hospital wards to GP surgeries. All will have undergone specialist training to work with people with mental health problems and many will do additional training to work in the Community. Most Community Mental Health Nurses (CMHNs) in Herefordshire are members of a Community Mental Health Team planning and delivering care with other mental health professionals.

A CMHN's role may be wide but is likely to include:

	working with people who have had severe mental health problems for many years and require long term support
	working with people with acute short term difficulties
	administering psychiatric drugs
	coordinating the care given by the CMHT to Service Users on their caseload

Social Workers

Specialist mental health social workers also work as members of Community Mental Health Teams. They provide a social work service to people with severe and enduring mental health difficulties who have been assessed by their GPs as needing input from the secondary mental health services. While Social workers should be able to offer advice on practical matters, many will also have skills in a range of non medical approaches to helping people with mental health problems (e.g. counselling or helping families or carers). Like other CMHT staff, Social Workers carry out assessments of the needs of service users and their carers and in conjunction with their colleagues formulate care plans and arrange for appropriate services to meet those needs. They also co-ordinate the care given by the CMHT to people on their caseload.

Approved Social Workers (ASWs) have the additional legal duty of carrying out assessments under the Mental Health Act 1983 for compulsory admission to hospital of people who have a mental disorder. The assessment is undertaken jointly with a consultant psychiatrist and the persons GP. ASW's have a particular responsibility in this situation to examine alternatives to hospitalisation. However if following assessment the joint recommendation is that compulsory admission is necessary it is then the ASWs job to arrange for that person to be physically conveyed to hospital.

Psychologists

Clinical Psychologists have a first degree in psychology and a postgraduate qualification formerly at Master's or Diploma now at Doctoral level in clinical psychology. Their training includes the application of scientific principles to the understanding of human experience, actions, thoughts, feelings and behaviour, the basis of the so called scientific practitioner model.

Training also includes a thorough grounding in a wide range of psychological theories, therapeutic models and practices applicable to the wider health context and the basics of research/enquiry and comprehensive training in assessment.

Clinical Psychologists can offer extensive assessment followed by a wide range of 'talking and listening' therapies to help individuals, couples, families and groups. (They do not prescribe medication or ECT.) They can also advise at an organisational level.

Occupational Therapists (OTs)

OTs are trained to help people with physical or mental health problems cope with daily living. Mental Health Service OTs work in both hospitals and CMHTs and help people learn or relearn skills lost because of mental ill health. The focus of Occupational Therapy is on helping a person reach their potential in their work, social and home lives. Occupation means any way in which we spend our time from: personal care (e.g. getting dressed, cleaning teeth, washing, shopping); to productivity (e.g. paid or unpaid work, housework or education); to leisure (sports games hobbies social life)
People with mental health problems often find their illness affects their ability to function in some or all these aspects of their lives. OTs work with service users to identify particular areas of deficit and devise programmes of care to help them overcome them.
Thus an OT's work may be quite different depending on where he/she works and the nature of the difficulties faced by his/her clients. For instance It could involve assessment for the provision of aids and adaptations to enable an older or disabled person to live independently at home; or individual or group work with people who have mental health problems.
Like other CMHT members Occupational Therapists have a caseload and responsibility for co-ordinating the care give by the team to people on it.

Community Support Workers and Nursing Assistants

Nursing assistants work on wards while community support workers, employed by Social Services, work in the community as part of CMHTs. They do not have a professional qualification, but often receive in-service training or work for a National Vocational Qualification (NVQ). They may provide practical and/or emotional support.

Psychotherapists and Counsellors

There are psychotherapists and counsellors working within the NHS and a great many privately. The distinction between psychotherapy and counselling is not always a clear one. You can expect any mental health professional you see to have at least a grounding in basic counselling skills and many will have many years experience of working with mental and emotional problems. However the majority of mental health staff do not have specific counselling of psychotherapy qualifications.

Psychotherapists and Counsellors sometimes do a primary training in one of the above professions and but will have in addition received specialist psychotherapy or counselling training. Others may gave become counsellors or psychotherapists without any previous professional experience. Psychotherapy training tends to be more rigorous than that for counselling and usually involves the trainee undergoing their own therapy as part of it.
For more information about counselling and psychotherapy

Art Therapists

Art Therapists are trained in a form of psychotherapy in which the client creates some form of artwork such as a painting, clay sculpture, or collage. The artwork is then used as a focus for reflection in words between the client and therapist or group. Art therapy can be particularly helpful to people who find it difficult or even impossible to talk directly about painful or troubling thoughts or memories but who are able to approach them indirectly using their hands and their imagination. Art therapists use their client's artwork in much the same way as some psychotherapists use dreams, i.e. as a way of accessing and working with unconscious conflicts that may be at the root of a persons emotional or mental disturbance.

Many people are put off art therapy because they are "no good at art". Art Therapy is specifically not about creating "art" for any aesthetic purpose nor is the art work intended to be used in any way other than as a route to helping people resolve problems.